An adapted Arabic version of the Test of Nine Images for the illiterate Lebanese population: Validation and preliminary normative data.

OBJECTIVES: In the absence of a simple validated instrument to screen for cognitive impairment among illiterate Lebanese older adults, the aims of this study were to validate an Arabic version of the Test of Nine Images (A-TNI93) adapted by the Working Group on Dementia at Saint Joseph University: Groupe de Travail sur les Démences de l'Univesité Saint Joseph (GTD-USJ) for illiterate older Lebanese and to establish normative data. METHOD: A national population-based sample of 332 community-dwelling illiterate Lebanese aged 55 years and older was administered the A-TNI93 (GTD-USJ) scoring free and overall recall. The sample is part of a larger national sample (1342 participants) used to validate an Arabic version of the Mini-Mental State Examination already reported. Reproducibility, sensitivity, specificity, and area under the curve of the A-TNI93 (GTD-USJ) scoring to detect cognitive impairment according to Clinical Dementia Rating (CDR) as the gold standard were measured. Normative data were established among 188 cognitively normal participants. RESULTS: A threshold score of six on free recall (FR) provided a sensitivity of 66.7% and a specificity of 90.5%. The area under the curve was 0.93. By taking either scores, that is, a FR ≤ 6 or a total recall ≤ 8, the A-TNI93 (GTD-USJ) slightly improved dementia case detection with a sensitivity of 70.8% and a specificity of 88%. Normative data illustrate the distribution of cognitive performance among illiterate older adults. CONCLUSIONS: Compared to the CDR requiring physician's competence, the A-TNI93 (GTD-USJ) is a valid Arabic adaptation to screen for cognitive impairment among illiterate Lebanese older adults.

Validity and reliability of a food frequency questionnaire for community dwelling older adults in a Mediterranean country: Lebanon.

BACKGROUND: Food frequency questionnaires (FFQ) is an easy and inexpensive tool that can be used to evaluate nutrient and dietary trends of groups and individuals. Few studies in the East Mediterranean region tailored FFQs to describe dietary intakes of older adults. The purpose of the study is therefore to assess the validity and reproducibility of a FFQ, designed for use with older adults living in a Mediterranean Arabic speaking country, Lebanon. METHODS: The FFQ is composed of a list of 90 food items, commonly consumed by adults above 60 years of age. Validity of the FFQ was tested using the mean of two 24-hours dietary recalls (24HDR), and reproducibility, by repeating the questionnaire within a one-month period, along the second dietary recall. Our study included 42 and 76 participants, for the repoducibility and validity analysis respectively. Subjects were randomly selected from 2 of the 8 governorates in the country. RESULTS: FFQ reproducibility showed a mean relative difference of 1.03% without any significant difference between all paired components of nutrients. Intra class correlation (ICC) showed good and excellent reliability for caloric intake and all macronutrients, moderate to good reliability for all remaining nutrients, except for poly-unsaturated fatty acids, vitamins A, B12 and fibers. Correlation coefficients for all nutrients were fair to strong. Both administrations of the FFQ showed good internal validity. Validation of FFQ showed a mean relative difference between FFQ and mean 24HDR at 19.5%. Agreements between the 2 methods, for classifying individuals in the same or adjacent quartile, for nutrient intake and nutrient adequacy, were 80 and 78.2% respectively. Mean Kappa coefficient was 0.56 and energy-adjusted correlations were within the recommended values for all items except for vitamin A and B12. Adjusting for nutrient-dense food intake improved the agreement for theses 2 vitamins to 0.49 and 0.56, respectively. CONCLUSION: The proposed FFQ can be considered a valid tool to help describe nutrient intake of older individuals in an Arabic speaking Mediterranean country. It could serve for possible use in the East Mediterranean region for the evaluation of regular dietary intake of community-dwelling older adults.

Lebanese People Living with HIV: Psychiatric Co-morbidities and Psycho-Social Environment.

Data are lacking on the psychiatric and psycho-social profiles of Middle-Eastern people living with HIV (PLHIV). Our study aimed to establish the prevalence and correlates of mental illness in a sample of Lebanese PLHIV, and to delineate their socio-cultural reality. PLHIV, either attending a private ID clinic or a non-governmental organization, were interviewed. A total of 94 patients were included. Sixty-nine (73.4%) were found to have at least one psychiatric disorder. Only nine participants were currently receiving psychotropic medications. The most common diagnosis was major depression, occurring in half of the subjects. Homosexual or bisexual orientation predicted the presence of a current depression (p = 0.024), and ART status was negatively associated with current depression (p = 0.028). The rate of psychiatric disorders is clearly higher than that of the general population. PLHIV with a homosexual or bisexual orientation face a double stigma, perhaps making them more vulnerable to depression. Our findings need to be replicated in larger studies with more representative samples.

Sarcopenia negatively affects hip structure analysis variables in a group of Lebanese postmenopausal women.

BACKGROUND: The current study's purpose is to compare hip structural analysis variables in a group of postmenopausal women with sarcopenia and another group of postmenopausal women with normal skeletal muscle mass index. To do so, the current study included 8 postmenopausal women (whose ages ranged between 65 and 84 years) with sarcopenia and 60 age-matched controls (with normal skeletal muscle mass index (SMI)). Body composition and bone parameters were evaluated by dual-energy X-ray absorptiometry (DXA). RESULTS: Weight, lean mass, body mass index, femoral neck cross-sectional area (FN CSA), FN section modulus (Z), FN cross sectional moment of inertia (CSMI), intertrochanteric (IT) CSA, IT Z, IT CSMI, IT cortical thickness (CT), femoral shaft (FS) CSA, FS Z and FS CSMI were significantly greater (p < 0.05) in women with normal SMI compared to women with sarcopenia. In the whole population, SMI was positively associated with IT CSA, IT Z, IT CSMI, IT CT, FS CSA, FS Z, FS CSMI, FS CT but negatively correlated to IT buckling ratio (BR) and FS BR. CONCLUSION: The current study suggests that sarcopenia has a negative effect on hip bone strength indices in postmenopausal women.

WHAT IS THE HEALTH STATUS OF INSTITUTIONALIZED ELDERLY IN LEBANON? A Preliminary Cross-Sectional National Survey.

BACKGROUND: Medical conditions and depen- dency levels of the elderly in the Lebanese long-term care institutions have not been described. This may undermine care commissioning and development to institutionalized elderly. Data to inform policy and practice are needed. OBJECTIVE: To identify clinical diagnoses and dependency levels among elderly residents in long-term care institutions in Lebanon. METHODS: Cross-sectional survey of long-term care institutions throughout Lebanon as identified by the Mihistry of Social Affairs. RESULTS: Thirty-one out of 42 long- term care institutions have been included in this survey. Among them, 1371 elderly subjects were included in the analysis; 75.6% were over the age of 75, and female repre- sented 67%. Medical morbidities and associated disabilities have driven admission in 70.5% of residents; 45.6% of resi- dents reported dernentia, stroke or other neurodegenerativb disease. Overall, 60% of residents required locomotor assis- tance. CONCLUSIONS: Elderly residents in long-term carb institutions are predominantly females, with mental and/or locomotor disabilities resulting fror neurological and ar- thritic conditions. Targeting healthcare for such health condi- tions remains a challenge for the institutions.

[Geriatric profile according to the Identification of Seniors At Risk (ISAR) tool in the emergency department in a teaching hospital]. / PROFIL GÉRIATRIQUE selon l'INSTRUMENT IDENTIFICATION SYSTÉMATIQUE des AÎNÉS à RISQUE (ISAR) au SERVICE des URGENCES d'un CENTRE HOSPITALIER UNIVERSITAIRE.

BACKGROUND: With the anticipated increase in the number of elderly people in Lebanon, it is important to develop services tailored to their specific needs. The Identification of Seniors At Risk (ISAR) tool identifies, in emergency setting, frail elderly people at risk of adverse outcomes, who are more likely to benefit from a geriatric approach. OBJECTIVES: i) Assess the geriatric profile according to ISAR score ii) correlate the score to outcomes two months after Emergency Department (ED) visit. METHODS: A two-month prospective study: at the ED of Hôtel-Dieu de France Hospital, we interviewed 273 people aged 70 years and older (or their caregiver) using the ISAR tool. Telephone follow-up was done two months later. RESULTS: The prevalence of subjects with ISAR score ≥ 2 and thus likely to benefit from the establishment of a geriatric service is 70.7% (95% CI: 64.9-76.0). Elderly patients admitted to ED with ISAR score ≥ 2 are more likely to be hospitalized (51.6%) than subjects of the same age and sex with ISAR score < 2 (36.9%) (p = 0.034). After two months of follow-up, the risk of hospital readmission and the risk of death was significantly associated with the ISAR score (p = 0.0005) CONCLUSION: The percentage of elderly people likely to benefit from specialized geriatric care network upon admission to the ED of a university hospital is significantly high [70.7% (95% Cl: 64.9-76 .0)].

Geometric indices of hip bone strength in overweight and control elderly men.

AIM OF THE STUDY: The aim of this study was to compare geometric indices of hip bone strength in overweight and control elderly men. METHODS & RESULTS: This study included 16 overweight (Body mass index (BMI) > 25 kg/m2) elderly men (aged 65-84 years) and 38 age-matched controls (BMI < 25 kg/m2). Body composition and bone mineral density (BMD) were assessed by dual-energy X-ray absorptiometry (DXA). To evaluate hip bone geometry, DXA scans were analyzed at the femoral neck, the intertrochanteric region, and the femoral shaft by the Hip Structure Analysis (HSA) program. Cross sectional area (CSA), an index of axial compression strength, section modulus (Z), an index of bending strength, cross sectional moment of inertia (CSMI), an index of structural rigidity, cortical thickness (CT) and buckling ratio (BR) were measured from bone mass profiles. Lean mass, body weight, fat mass and BMI were higher in overweight men compared to controls (p < 0.001). CSA and Z were higher in overweight subjects compared to controls (p < 0.05) at the three regions (femoral neck, intertrochanteric and femoral shaft). After adjustment for age, CSA and Z of the intertrochanteric region and the femoral shaft remained significantly higher in overweight men compared to controls (p < 0.05). After adjustment for either body weight, BMI or lean mass, there were no differences between the two groups (overweight and controls) regarding the HSA variables (CSA, CSMI, Z, CT and BR) of the three regions. CONCLUSION: This study suggests that overweight elderly men have greater indices of bone axial and bending strength in comparison to controls at the intertrochanteric and the femoral shaft.

Bone mineral content and density in obese, overweight and normal weight adolescent boys.

AIM OF THE STUDY: The aim of this study was to compare bone mineral content (BMC), bone mineral density (BMD) and bone mineral apparent density (BMAD) in obese, overweight and normal weight adolescent boys. METHODS & RESULTS: This study included 23 obese, 19 overweight and 25 normal weight adolescents (aged 14-20 years) boys. The three groups (obese, overweight and normal weight) were matched for age and maturation index. Body composition, BMC and BMD were assessed by dual-energy X-ray absorptiometry (DXA). The expressions whole body (WB) BMC/height and WB BMD/height were used to adjust for WB bone size. BMAD was calculated for the WB. WB BMC, WB BMC/height, total hip (TH) BMD, femoral neck (FN) BMD and ultra distal (UD) radius BMD) were higher in obese and overweight boys in comparison to normal weight boys (p < 0.05). WB BMAD was lower in obese boys in comparison to overweight and normal weight boys (p < 0.05). After adjustment for either weight or lean mass, obese boys displayed lower WB BMC, WB BMC/height and WB BMD values in comparison to overweight and normal weight boys (p < 0.05). CONCLUSION: This study suggests that WB BMC, WB BMC/height and WB BMD do not adapt to the increased body weight in obese adolescent boys.

Letter and Category Fluency: Normative Data for Lebanese Older Adults.

BACKGROUND: Verbal fluency tasks are frequently used for neuropsychological assessment in clinical practice and research. It consists of two tasks namely category and letter fluency tests. OBJECTIVE: To determine normative values in category (animals, vegetables, fruits) and letter fluency [Mim () "M", Alif () "A", Baa () "B"] tasks in Arabic language in 60 s. METHODS: This study was a cross-sectional national survey and included 859 community-dwelling, cognitively intact Lebanese residents aged ≥55 years. Norms were presented according to age (55-64 years, 65-74 years, ≥75 years), sex and level of education (illiterate, no diploma, primary certificate, baccalaureate or higher). RESULTS: Level of education had the most significant positive effect on verbal fluency tasks performance amongst Lebanese older adults. The negative effect of older age was more prominent in the category fluency task compared to the letter fluency task. Women outperformed men in vegetables and fruits categories. CONCLUSION: This study provides clinicians with normative scores of category and letter fluency tests, which can be used for neuropsychological assessment of older Lebanese patients being evaluated for cognitive disorders.

Anthropometric predictors of geometric indices of hip bone strength in a group of Lebanese postmenopausal women.

The effects of anthropometric characteristics on hip bone strength in postmenopausal women are not completely elucidated. The aim of this study was to investigate the influence of anthropometric characteristics on geometric indices of hip bone strength using the hip structure analysis (HSA) program in a group of Lebanese postmenopausal women. This study included 109 postmenopausal women (aged 64--84yr). Age and years since menopause were recorded. Body composition and bone mineral density were assessed by dual-energy X-ray absorptiometry (DXA). To evaluate hip bone strength, DXA scans were analyzed at the femoral neck (FN), the intertrochanteric (IT), and the femoral shaft (FS) by the HSA program. Cross-sectional area (CSA), an index of axial compression strength, section modulus (Z), an index of bending strength, and buckling ratio (BR), an estimate of cortical stability in buckling, were measured from bone mass profiles. Using univariate analysis, weight, height, body mass index (BMI), lean mass, and fat mass were positively correlated to CSA and Z of the FN, IT, and FS. Weight, BMI, fat mass, and fat mass percentage were negatively correlated to BR of the FN, IT, and FS. Multiple linear regression analysis showed that lean mass was a stronger determinant of FN CSA, FN Z, IT Z, and FS Z than fat mass, whereas fat mass was a stronger determinant of IT CSA, FS CSA, IT BR, and FS BR than lean mass. This study suggests that, in postmenopausal women, fat mass is a strong predictor of hip axial compression strength and cortical stability in buckling, and lean mass is a strong predictor of hip bending strength.

Use of complementary and alternative therapy among patients with rheumatoid arthritis and osteoarthritis.

AIMS AND OBJECTIVES: We wanted to assess the prevalence of complementary and alternative therapy use among patients suffering from rheumatoid arthritis or osteoarthritis in the Lebanese population and to determine the perceived efficacy and side effects of complementary and alternative therapy in the treatment of these diseases. BACKGROUND: Complementary and alternative therapy has become popular among patients with chronic illnesses because of its widespread use. Rheumatoid arthritis and osteoarthritis are two diseases associated with severe pain, inflammation and limited activity. Although both are quite common in Lebanon, no studies were conducted in our country to portray complementary and alternative therapy use in their treatment. DESIGN: Descriptive cross-sectional study. METHODS: Conducted individualised questionnaire-based interviews among 250 adult patients, ranging between the ages of 20-90 years and diagnosed with either rheumatoid arthritis or osteoarthritis. The questionnaire included demographic information, clinical information, use of conventional therapies and complementary and alternative therapy, and the disease status before and after complementary and alternative therapy use. RESULTS: Fifty-eight (23·2%) patients used complementary and alternative therapy in addition to their conventional medications in the treatment of either rheumatoid arthritis or osteoarthritis. Most herbal medicine users (63·8%) believed that complementary and alternative therapy was beneficial. The disease status measured by the intensity of pain, sleeping pattern and level of activities was significantly improved after using complementary and alternative therapy (p =0·01). Forty-eight (82·75%) patients were using herbals as complementary and alternative therapy, 14 (24·1%) of whom have sought medical care because of potential concomitant drug-complementary and alternative therapy side effects. However, these side effects were not serious and reversible. CONCLUSION AND RECOMMENDATIONS: Although complementary and alternative therapy might have beneficial effects in rheumatoid arthritis and osteoarthritis, patients should be cautious about their use and should necessarily inform their health care providers about the consumption of any products other than their conventional medicines. RELEVANCE TO CLINICAL PRACTICE: It is quite essential for health care professionals to be knowledgeable about the use of complementary and alternative medicine therapies when providing medical care to patients with arthritis.

Relative importance of lean mass and fat mass on bone mineral density in a group of Lebanese elderly men.

METHODS AND RESULTS: Seventy Lebanese men (aged 65-84 years) participated in this study. Body weight and height were measured and body mass index (BMI) was calculated. Body composition (lean mass, fat mass and fat mass percentage) was assessed by dual-energy X-ray absorptiometry (DXA). Bone mineral content (BMC) of whole body (WB) and BMD of WB, total hip (TH), femoral neck (FN), ultra distal (UD) radius and 1/3 radius were measured by DXA. The ratios WB BMC/height and WB BMD/height were calculated. Fat mass and lean mass were found to be positively correlated to WB BMC, WB BMC/height, and to WB, TH, FN, UD radius and 1/3 radius BMD. After controlling for age and height, fat mass was more strongly correlated to TH BMD and FN BMD than lean mass while lean mass was more strongly correlated to WB BMC, WB BMD, UD radius BMD and 1/3 radius BMD than fat mass. CONCLUSION: This study suggests that, in elderly men, fat mass is a stronger determinant of TH and FN BMD than lean mass while lean mass is a stronger determinant of WB BMC, WB BMD, UD radius BMD and 1/3 radius BMD than fat mass.

Influence of the weight status on hip bone strength indices in a group of sedentary adolescent girls.

OBJECTIVE: The aim of this study was to compare femoral shaft and intertrochanteric geometry in overweight and normal weight adolescent girls. METHODS AND RESULTS: This study included 22 overweight (Body mass index (BMI) > 25 kg/m2) adolescent girls (15.4 +/- 2.4 years old) and 20 maturation-matched (15.2 +/- 1.9 years old) controls (BMI < 25 kg/m2). Body composition and BMD were assessed by dual-energy X-ray absorptiometry (DXA). To evaluate bone geometry, DXA scans were analyzed at the femoral shaft and the intertrochanteric region by the Hip Structure Analysis (HSA) program. Cross-sectional area (CSA), an index of axial compression strength, section modulus (Z), an index of bending strength, cross-sectional moment of inertia (CSMI), cortical thickness (CT) and buckling ratio (BR) were measured from bone mass profiles. Lean mass, body weight, fat mass and BMI were higher in overweight girls compared to controls (p < 0.001). CSA, Z, CSMI and CT were higher in overweight girls compared to controls (p < 0.05) at the two regions (femoral shaft and intertrochanteric). After adjustment for maturation index (years since menarche), CSA, Z, CSMI and CT of the intertrochanteric region and CSA of the femoral shaft were higher in overweight girls compared to controls (p < 0.05). After adjustment for either body weight, lean mass or BMI, using a one-way analysis of covariance (ANCOVA), there were no differences between the two groups (overweight and controls) regarding the HSA variables (CSA, CSMI, Z, CT and BR) at the femoral shaft and the intertrochanteric. CONCLUSION: This study suggests that overweight adolescent girls have greater indices of bone axial and bending strength in comparison to controls at the intertrochanteric after adjustment for maturation index.

Hip bone strength indices in overweight and control adolescent boys.

The influence of being overweight on bone strength in adolescents remains controversial. The aim of this study was to compare hip bone strength indices in overweight and control adolescent boys using hip structure analysis (HSA). This study included 25 overweight adolescent boys [body mass index (BMI) >25 kg/m(2)] and 31 maturation-matched controls (BMI <25 kg/m(2)). Body composition and bone mineral density were assessed by dual-energy X-ray absorptiometry (DXA). To evaluate hip bone strength, DXA scans were analyzed at femoral neck, intertrochanteric, and femoral shaft by the HSA program. Cross-sectional area (CSA), an index of axial compression strength, section modulus (Z), an index of bending strength, cross-sectional moment of inertia (CSMI), cortical thickness (CT), and buckling ratio (BR) were measured from bone mass profiles. Body weight, lean mass, fat mass, and BMI were higher in overweight boys compared to controls (P < 0.001). CSA, CSMI, and Z of the three sites (femoral neck, intertrochanteric, and femoral shaft) were higher in overweight boys compared to controls (P < 0.01). BR was not significantly different between the two groups at the three sites. After adjustment for either body weight, BMI, or fat mass, using a one-way analysis of covariance, there were no differences between the two groups regarding the HSA variables (CSA, Z, CSMI, CT, and BR). After adjusting for lean mass, overweight boys displayed higher values of femoral shaft CSA, CSMI, and Z in comparison to controls (P < 0.05). In conclusion, this study suggests that overweight adolescent boys have greater indices of bone axial and bending strength in comparison to controls at the femoral neck, the intertrochanteric, and the femoral shaft.

Characterization of papillary projections in benign versus borderline and malignant ovarian masses on conventional and color Doppler ultrasound.

OBJECTIVE: The purpose of our study was to evaluate on endovaginal ultrasound the morphologic and color Doppler characteristics of papillary projections in benign compared with borderline and malignant epithelial stromal ovarian tumors. MATERIALS AND METHODS: A total of 283 women (mean age, 52 years; age range, 20-85 years) with 343 operated adnexal masses comprising 167 epithelial stromal tumors of the ovary with 76 tumors containing papillary projections at pathology were retrospectively studied on ultrasound. We systematically evaluated the topography of the papillary projections, the morphologic features of the largest papillary projection, and the presence or absence of color Doppler findings. All these findings were correlated with macroscopic and microscopic features. RESULTS: Ultrasound detected papillary projections in 78% of tumors. Papillary projections were disseminated in 33% of malignant, 20% of borderline, and 0% of benign tumors (p = 0.0049). The mean size of the papillary projections was 9.6, 15.7, and 35.3 mm in benign, borderline, and malignant tumors, respectively (p = 0.0007). An acute angle was present in 68% of benign tumors and an obtuse angle in 40% of borderline and 89% of malignant tumors (p = 0.0001). The surface was regular in 77% of benign tumors and irregular in 50% of borderline and 88% of malignant tumors (p = 0.0000). Calcifications were present only in benign tumors (18%). For papillary projections ≥ 10 mm, color flow was present in all malignant, in 86% of borderline, and absent in all benign tumors. CONCLUSION: Association of morphologic and vascular ultrasound findings can highly suggest the diagnosis of benign or malignant papillary projection.

Relative importance of lean mass and fat mass on bone mineral density in a group of Lebanese postmenopausal women.

The aim of this study was to determine the relative importance of lean mass and fat mass on bone mineral density (BMD) in a group of Lebanese postmenopausal women. One hundred ten Lebanese postmenopausal women (aged 65-84 yr) participated in this study. Age and years since menopause were recorded. Body weight and height were measured and body mass index (BMI) was calculated. Body composition (lean mass, fat mass, and fat mass percentage) was assessed by dual-energy X-ray absorptiometry (DXA). Bone mineral content (BMC) of the whole body (WB) and BMD of the WB, the lumbar spine (L1-L4), the total hip (TH), the femoral neck (FN), the ultra distal (UD) Radius, and the 1/3 Radius were measured by DXA. The expressions WB BMC/height and WB BMD/height were also used. Weight, BMI, fat mass, and lean mass were positively correlated to WB BMC, WB BMC/height, WB BMD/height, and to WB, L1-L4, TH, FN, UD Radius, and 1/3 Radius BMD. However, using multiple linear regression analyses, fat mass was more strongly correlated to BMC and to BMD values than lean mass after controlling for years since menopause. This study suggests that fat mass is a stronger determinant of BMC and BMD than lean mass in Lebanese postmenopausal women.

Bone mineral content and density in overweight and control adolescent boys.

The aim of this study was to compare bone mineral content (BMC) and areal bone mineral density (aBMD) in overweight and control adolescent boys. This study included 27 overweight (body mass index [BMI] > 25 kg/m²) adolescent (17.1 ± 2.1 yr old) boys and 29 maturation-matched (16.7 ± 2.0 yr old) controls (BMI< 25 kg/m²). Bone mineral area (BMA), BMC, and aBMD were assessed by dual-energy X-ray absorptiometry (DXA) at the whole body (WB), lumbar spine (L2-L4), total hip (TH), femoral neck (FN), and left forearm (ultra distal [UD], mid Radius, 1/3 Radius, and total Radius). Body composition (lean mass, fat mass, and fat mass percentage) was assessed also by DXA. The expressions WB BMC/height, WB aBMD/height, and WB BMAD were used to adjust for WB bone size. WB BMC, WB BMC/height, WB BMA, L2-L4 aBMD, TH aBMD, FN aBMD, and UD aBMD were higher in overweight boys compared with controls (p < 0.05). However, WB BMAD was lower in overweight boys compared with controls (p < 0.05). After adjustment for weight, lean mass, or BMI, using a one-way analysis of covariance, there were no differences between the 2 groups (overweight and controls) regarding bone characteristics (BMC, BMA, aBMD, BMC/height, aBMD/height, and BMAD of the WB and aBMD of the lumbar spine; the TH; the FN; and the forearm). In conclusion, this study shows that after adjusting for weight, lean mass, or BMI, there are no differences between overweight and control adolescent boys regarding aBMD values.

Bone mass in a group of Lebanese girls from Beirut and French girls from Orleans.

AIM OF THE STUDY: To compare bone mineral content (BMC) and bone mineral density (BMD) in a group of Lebanese girls from Beirut and French girls from Orléans. METHODS: This study included 26 French adolescent girls (153 +/- 0.7 years old) and 24 maturation-matched (15.4 +/- 1.1 years old) Lebanese adolescent girls. BMC, BMD at the whole body (WB) and body composition (lean mass and fat mass) were assessed by dual-energy X-ray absorptiometry (DXA). Calculations of the bone mineral apparent density (BMAD) and the ratio BMC/height were completed for the WB. Weight and height were similar in the two groups. RESULTS: Lean mass was higher in French girls compared to Lebanese girls (p < 0.05). In the whole population, lean mass was a positive determinant of BMC and BMD. French girls displayed higher values of BMC, BMD, BMC/height and BMAD than Lebanese girls (p < 0.05). Finally, BMC and BMD remained higher in French girls in comparison to Lebanese girls even after adjusting for lean mass. CONCLUSION: In this study group, Lebanese girls have lower BMC and BMD in comparison to French girls.

Vitamin D3 Dose Requirement That Raises 25-Hydroxyvitamin D to Desirable Level in Overweight and Obese Elderly.

CONTEXT: Guidelines for the dosage of vitamin D supplementation vary widely globally. OBJECTIVE: To investigate the impact of 2 vitamin D doses, bracketed between the IOM recommended dietary allowance (RDA) and the upper tolerable limit, on vitamin D nutritional status in elderly individuals. METHODS: This post hoc analysis of data collected from a 12-month, double-blind, randomized control trial included 221 ambulatory participants (≥ 65 years) with a mean BMI of 30.2 kg/m2 and a mean baseline serum 25-hydroxyvitamin D [25(OH)D] level of 20.4 ±â€…7.4 ng/mL, who were recruited from 3 outpatient centers in Lebanon. All participants received 1000 mg of elemental calcium daily from calcium citrate plus the daily equivalent of either 600 IU or 3750 IU of vitamin D3. RESULTS: Mean 25(OH)D level at 12 months was 26.0 ng/mL with low dose and 36.0 ng/mL with high dose vitamin D3. The proportion of participants reaching a value ≥ 20 ng/mL was 86% in the low dose, and 99% in the high dose arms, with no gender differences. The increment of 25(OH)D per 100 IU/day was 1 ng/mL with the low dose, and 0.41 ng/mL with the high dose. Serum 25(OH)D levels at 1 year were highly variable in both treatment arms. Baseline 25(OH)D level and vitamin D dose-but not age, BMI, gender, or season-were significant predictors of serum 25(OH)D level post-intervention. CONCLUSION: The IOM Recommended Dietary Allowance (RDA) of 600 IU/day does not bring 97.5% of ambulatory elderly individuals above the desirable threshold of 20 ng/mL. Country-specific RDAs are best derived taking into account the observed variability and predictors of achieved 25(OH)D levels.